Calculation of intraocular lens power after trabeculectomy

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PURPOSE

To assess biometric changes in eyes after trabeculectomy (TE) and its impact on refractive outcomes of phacoemulsification (PE) in order to determine the corrections for calculation of intraocular lens (IOL) power.

MATERIAL AND METHODS

The study included two groups of patients: the 1^st group consisted of 116 patients who were assessed by optical biometry (IOL-Master 500) for mean biometric values before and after TE; the 2^nd group included 31 patients with history of TE (study subgroup) and 47 individuals without glaucoma (control subgroup) who underwent PE with subsequent comparison of IOL calculation accuracy.

RESULTS

There was significant axial length (AL) shortening in the 1^st group from 23.28±0.97 to 23.19±0.97 mm (p<0.001) 6 months after TE, which positively correlated (r=0.296, p=0.001) with intraocular pressure (IOP) decrease (from 25.4±5.34 to 17.2±4.42 mm Hg, p<0.001). Mean keratometry and anterior chamber depth values did not significantly change after TE. Mean IOL power calculation error after PE in the 2^nd group was –0.05±0.47 D and 0.003±0.62 D for the control and study subgroups, respectively (p=0.697). However, significant impact of preoperative IOP on IOL power calculation error was discovered in the study subgroup (R²=0.526, p<0.001), but not in the control subgroup (R²=0.061, p=0.052). Based on linear regression, the expected IOL power calculation errors depending on the preoperative IOP were determined for patients with history of TE.

CONCLUSION

AL shortening due to decrease in IOP in patients with history of TE leads to IOL power calculation errors. Expected IOL calculation error related to preoperative IOP level was determined, which could help improve refractive outcomes of PE in patients with history of TE.

Keywords:

IOL power calculation

biometry

axial length

intraocular pressure

phacoemulsification

glaucoma

trabeculectomy

Authors:

Belov D.F.

Saint Petersburg Multifield Hospital No. 2

Nikolaenko V.P.

City Multidisciplinary Hospital No. 2;
Saint Petersburg State University

Received:

01.07.2020

Accepted:

01.09.2020

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